Face Lift: Surgery and Techniques Overview

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If you think you look older than you should--or older than you feel—you might be considering a face lift. A face lift can improve your appearance by reducing sagging and wrinkling in the lower face and neck. A face lift can make you look younger and more refreshed and give you a new, vibrant look.

The medical term for a face lift is rhytidectomy. The word rhytidectomy derives from rhytis, the Greek word for wrinkles, and it means excision of wrinkles, which is a pretty good description of the procedure.

A face lift can correct or minimize wrinkles, and correct jowls around the jaw line. These signs of age may be a result of gravity, the loss of elasticity in your skin, exposure to the sun, or the stress associated with everyday life. A face lift cannot correct crow's feet at the corners of the eyes, other wrinkles around the eyelids, or the thin vertical wrinkles around the lips. But if sagging skin, wrinkles, and jowls have started to appear around your middle and lower face, a face lift can probably help you look younger.

Are You a Candidate for a Face Lift?

The amount of rejuvenation you can get with a face lift depends on how much wrinkling and sagging you had before your surgery. If your signs of aging are minimal, then the improvement from a rhytidectomy may be quite subtle. If your wrinkling and sagging is significant, then the results of your face lift could be dramatic.

If you are thinking of having a face lift, you should consult with a board-certified plastic surgeon. Making the decision to have a face lift requires a lot of thought.  Many factors must be taken into consideration.

You must be in good physical health. You have to be free of any active diseases or other medical conditions, such as diabetes, high blood pressure, or asthma, or have them under control. Pre-existing health conditions make it difficult for you to endure the surgery and recovery period and increase the risk of complications. They can also contribute to a poor cosmetic outcome.

You need to be mentally healthy, too. The healing time after a face lift can be long and complicated. You must have patience and mental strength. Some patients become depressed after surgery and this temporary depression can worsen any pre-existing depression or mental illness.

You also must have realistic expectations about what a face lift can do for how you look. Before committing to a face lift surgery, you should discuss your expectations and how you want to look with your surgeon. A face lift can make you look years younger, but it cannot make you look decades younger. If you are in your 50s, a face lift may be able to take 10 to 15 years off your appearance. It cannot make you look like you did when you were 20. You should expect improvement, not perfection.

A face lift can be combined with other cosmetic procedures, such as a brow lift, a neck lift, or blepharoplasty. You may also benefit from facial skin resurfacing, which can help reduce or eliminate fine lines and wrinkles as well as age spots or old acne scars. Facial resurfacing can be done with a chemical peel, dermabrasion, or microdermabrasion, or with a laser peel. The procedures would be done after your face lift heals.

You and your surgeon can look at before-and-after face lift photos to be sure you are in agreement on what you want as the end result.

Health insurance almost never covers any costs associated with a face lift or any other procedures done strictly for cosmetic reasons. You will be responsible for all the fees, including the costs of postoperative visit's and prescriptions. However, you can arrange for financing by contacting NewImage.com.

If you are trying to lose a considerable amount of weight, you might consider putting off having a face lift until you reach your goal weight. If you have the lift now and lose weight later, you may end up with more loose skin that will undo the work of your surgeon.

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Face Lift Procedure Types and Techniques

There are several different types of face lifts. Some of these techniques are designed to improve the appearance over most of the face, while others are limited to specific areas. The different techniques vary by where the incisions are placed, whether they adjust skin only or the skin and its underlying tissue, what areas of the face they treat, and how invasive they are.

When it comes to a face lift, one size does not fit all. There are variations on each of these techniques and different surgeons may choose one or combine one or more of them to create a procedure that is customized for you.

In addition, you can have other cosmetic surgery performed at the same time as a face lift, such as blepharoplasty to correct droopy eyelids or a brow lift to correct a furrowed brow. A face lift can also be combined with liposuction under the chin. For that matter, it can be combined with cosmetic surgery to other parts of the body, such as liposuction of the abdomen or thighs or breast enhancement. In addition, skin resurfacing techniques done at a later date can rejuvenate your skin and remove fine lines and wrinkles.

Research in cosmetic plastic surgery is always moving forward and new techniques and variations  that offer improved results or greater safety are being developed.

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How a Face Lift Is Performed

The length of time required to complete a rhytidectomy depends on the technique used, but generally a face lift will take between 3 and 6 hours, longer if it is being combined with other procedures such as blepharoplasty. Most face lifts are performed either in a surgeon's office or at an outpatient surgery clinic and you go home the same day.

Before the start of the surgery, your surgeon will mark your face to indicate where he or she will make incisions, which are dictated by which technique is used. Your face will be scrubbed with an antiseptic to minimize the risk of infection. Your hair will be secured to ensure it does not get in the surgeon's way and sectioned off if any incisions are to be placed behind the hairline. Usually, an intravenous (IV) line will be started. You will also be hooked up to monitors to keep track of your vital signs.

The type of anesthesia to be used should be discussed by you and your surgeon before your surgery. Most face lifts are performed using local anesthesia, which numbs the face, and a sedative, which will make you feel drowsy and relaxed. You should not feel any pain, but you may feel some movement on your face as the surgery proceeds.

During the actual procedure, your surgeon will follow the premarked incision lines he or she made during the preparation phase. The exact surgery will depend on what type of face lift is being performed, but in most cases your surgeon will separate the skin of the face from the fat and the muscle beneath it. Excess fat may be removed if necessary, and the muscles can be tightened to create a more taut and youthful appearance. The skin is then pulled back over the muscles and excess skin is removed. The incisions will then be closed and a dressing will be applied to protect the wounds and reduce swelling.

After your surgery, you will be awakened and moved to a recovery room where the staff can monitor you for about 2 hours. During this time, you may feel some pain, soreness, disorientation, nausea or coldness. The staff can give you pain relievers, antinausea medications, and warm blankets.

You will not be allowed to drive yourself home after your surgery. You must have a responsible adult to drive you home. Your surgeon may also instruct you to have a friend or family member stay with you overnight if you live alone.

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The Scars of a Face Lift

If everything goes well with your face lift, you will not be able to see any scars. This does not mean that you will have no scars, just that there will be no visible scars.

Plastic surgeons have learned how to make incisions and choose incision placements so that scars are as inconspicuous as possible. Incisions may be hidden in or behind the hairline, in the natural folds of skin just in front of the ear, in the nasolabial folds, just under the eyelashes, or even in your mouth.

For many different types of face lifts, the incisions are made at the side of the face, starting just above the ear and running down in front of the ear and then up behind the ear a short distance. After adjustments are made to the facial structures under the skin and excess skin is removed, the incision is closed with very fine sutures.

When incisions are made in the hairline or behind the hairline, the surgeon will part the hair along the line where the incision will go. Your hair is then pinned out of the way while the incisions are made.  After excess skin has been removed, the incisions are closed. You may experience some hair loss around the edges of the incision, but this is usually temporary.

All incisions take time to heal. You cannot judge how visible a scar will be in the first few weeks after your surgery. Scars go through several stages as they mature and they may look red and prominent for a while after surgery, but then flatten and become pale.

The visibility of scars after a face lift depends on several factors, including the skill of your surgeon, any complications after surgery such as infection or necrosis (tissue death) around the wound, and how well you heal. Some people heal well and some people, especially smokers and diabetics, tend to heal poorly.

Some people are prone to either hypertrophic scarring or keloid growth. Hypertrophic scars are red and raised, but do not grow past the edges of the original wound. Keloids are scar tissue that can keep on growing and form benign lumps. They are more common in people of African or Asian descent and are more likely to occur on the back and shoulders.

Conversely, some incisions may sink as they heal. These can be raised to the level of the surrounding skin by injecting collagen or other injectable filler substances under the scar.

Your surgeon may suggest several ways to ensure that your incisions heal well and inconspicuously. He or she may recommend putting paper surgical tape or silicone sheeting over the incisions, which can help keep them flat or help flatten them if they become raised.

If your incisions do not heal well, there are treatments to help minimize the scars. These include dermabrasion, in which the top layer of the scar and skin around the scar are essentially sanded down, and further surgery to reduce the size of the scars or improve them in other ways.

The most common types of face lifts are:

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